Matters of Life and Death

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What if life expectancy expanded and we could live into our nineties and beyond in relative good health? That was one of the crucial questions debated in “Engineering Immortality,” a panel discussion at last week’s World Science Festival in New York City.

In introducing the sold-out program at NYU’s Global Center, host and ABC-TV news correspondent Bill Blakemore pointed out that American life expectancy has gone from 47 to 79 years in just a century. “Today’s scientists are growing hearts in the lab, creating organs with 3-D bio-printers, and eliminating cells that shorten life,” he said. “Will this new technology yield another dramatic increase in life expectancy?”

Joining Blakemore were four noted experts on aging: Joseph J. Fins, M.D., Dana Alliance member and a professor of medical ethics at Weill Cornell Medical College; James L. Kirkland, M.D., Ph.D., director of the Center on Aging at Mayo Clinic; Doris A. Taylor, Ph.D., director of regenerative medicine research at the Texas Heart Institute; and Jamie Metzl, Ph.D., senior fellow for technology and national security for the Atlantic Council.

The topic of chronological versus biological differences was introduced, and Kirkland pointed out that it’s impossible to distinguish biological differences between two first-graders, but that those differences diverge exponentially as people age. By the time those same two first-graders reach their 70s or 80s, one may be able to play 36 holes of golf while the other may not be able to swing a golf club. Chronological health is a given, but biological health is related to genetics and factors such as the rate of inflammation common in aging, nutrition, exercise, and environmental factors, he noted, adding that researchers prefer the term “health span” to life span. Health span links to quality of life, and is far more important than life span in decision-making for both clinicians and patients, the panelists agreed.

Fins brought up the question of whether longer life expectancy was always good for society, using his own period as a tenured professor to point out that qualified, younger academics who are anxious to advance are blocked. Metzl argued that the goal of medicine is to advance life and, if there is less opportunity for younger academics, then social constructs should change. “Adapt or adjust the rules so that a tenured professor must retire as age 60,” he said.

The panelists also talked about their difficult role counseling families about loved ones who were being kept alive by machines, a task that has become increasingly common as medicine improves. Diagnosing and attacking several chronic problems collectively, rather than trying to treat one chronic problem individually, has been a new approach in age research in recent years. “We have been able to show progress in treating mice with more than one problem, and now we have to see if we can expand health span in humans, even if it’s only for a few months,” said Kirkland.

Animal versus human research brought out a degree of feistiness in Taylor, who pointed to the great discrepancies between transitioning scientific findings from mice to health improvements in people. She also pointed out that in both animal and human subjects, males and females age differently, and the focus has been predominantly on males for far too long, mainly because women have menstrual cycles. “Women live longer—and are superior!” she quipped.

The five places in the world—dubbed Blue Zones—where National Geographic funding helped researchers discover where people live the longest, was mentioned before Metzl opined that resources regarding aging research are not allocated properly. “Why are we spending so much on the diseases and so little on understanding and targeting aging itself?” he said. “We need to better understand the basic science of aging from an evolutionary perspective.”

Fins offered some advice for many of the students in the audience who might have been thinking about the future. “Don’t wait until you’re 45 years old to check into an anti-aging clinic and ask for some magic bullet that’s going to make you live longer,” he said. “It’s never too early to have a multi-faceted approach to prevent the morbidity that’s downstream.”

– Bill Glovin

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